Iron Deficiency: Symptoms, Causes & Treatment

Iron deficiency is one of the most common deficiency symptoms worldwide. The risk groups are mainly women. But also the complete renunciation of meat and fish products in a vegetarian or vegan diet is one of the possible causes of an undersupply with  iron . What are the symptoms of iron deficiency, what consequences can it have and what can be done to remedy the deficiency? You can read that and more below.

What does the body need iron for?

Iron is an essential trace element that the body cannot produce itself and that we therefore have to get from food. It is particularly important for the formation of the red blood pigment hemoglobin and thus for oxygen transport. But iron is also of great importance for the body as a component of the “power plants” in the cells and of enzymes.

How much iron does a person need?

The iron requirement per day results from the daily iron loss through  sweat , urine and stool and is between one and two milligrams. Women also lose iron during their periods.

However, just one or two milligrams of iron per day is not enough. Because the body can only utilize about 10 to 15 percent of the iron in food. The German Society for Nutrition (DGE) therefore recommends a daily iron intake of between  10 and 15 milligrams per day for young people and adults,  with women having a higher requirement than men. Children should consume 8 to 15 milligrams of iron per day, pregnant women 30 milligrams and breastfeeding women 20 milligrams.

Causes of iron deficiency

The dietary iron covers at most the normal requirement. If this is increased, for example during pregnancy or heavy menstrual bleeding, there is an iron deficiency. In addition, an imbalance between iron requirement and iron supply can also have other causes:

• Increased need:  During pregnancy and breastfeeding, the increased need for iron cannot often be compensated for through food. In this case, iron tablets should be taken. Children in the growth phase and puberty also need more iron.
• Insufficient iron intake:  People who do not eat animal foods often have low iron levels. Although there is enough iron in plant foods, it is present in a form that the body has difficulty using.
• Iron loss:  Heavy menstrual bleeding, prolonged bleeding from ulcers, chronic inflammation in the gastrointestinal tract or bleeding  haemorrhoids  lead to iron loss. With high physical exertion, the loss of minerals and trace elements through the kidneys and perspiration increases, and the iron level also drops when donating blood.

Symptoms of iron deficiency

The body can compensate for an iron deficiency over a certain period of time, but symptoms and deficiency symptoms appear after some time. These include, for example, the following signs:

• brittle hair and nails, hair loss
• dry skin
• cracked and torn corners of the mouth (angular cheilitis)
• Mucosal changes in the mouth and esophagus
• burning tongue
• recurring  aphthae  of the oral mucosa
• Iron deficiency can sometimes be recognized by the lack of reddening of the lower eyelid

Other symptoms of low iron

If the number of oxygen-carrying red blood cells decreases, the oxygen supply to the cells also decreases. If the body has too little iron over a long period of time, anemia (iron deficiency anemia) occurs with the typical physical and psychological symptoms:

• persistent fatigue and exhaustion
• reduced performance, shortness of breath
• Poor concentration, forgetfulness and attention disorders
• Nervousness, inner restlessness, irritability, exhaustion
• paleness
• dizziness
• headache
• Tingling in hands and legs
• hypersensitivity to cold

The organism generally becomes more  susceptible to diseases. Palpitations and shortness of breath can also   occur. Severe iron deficiency anemia can also be accompanied by ringing in the ears, blurred vision,  drowsiness  and the absence of menstruation. Prolonged anemia can trigger cardiac insufficiency and, in the worst case, be fatal.

consequences of iron deficiency

In addition to anemia, iron deficiency can have other long-term consequences, such as Plummer-Vinson syndrome, which is associated with damage to the mucous membrane in the mouth and throat. Pica disease, in which people have deformed fingernails and nighttime muscle cramps, but also put nonedible things like metal and earth in their mouths, can also occur. In addition, people with an iron deficiency are more likely to store lead in their bodies.

Recognize iron deficiency: Diagnosis by blood test

If an iron deficiency is suspected, a  blood test can  provide clarity. Not only the  iron concentration in the blood should  be determined, but also the ferritin value and the transferrin value. The ratio of the values ​​can help determine the cause of the iron deficiency. For example, low iron levels combined with low ferritin levels indicate inflammation.

Sometimes a bone marrow test from the hip bone may also be needed to diagnose iron deficiency.

What to do with iron deficiency? 5 tips!

A slight iron deficiency can usually be remedied through diet, because there are a variety of iron-rich foods. But what to eat if you have an iron deficiency? These five tips can help you provide your body with enough iron:

1. Eat a serving of lean meat three to four times a week. Liver and offal contain a particularly large amount of iron.
2. Whole grain products and legumes such as lentils or white  beans  contain large amounts of iron and other valuable  minerals .
3. Combine meals with vegetables rich in vitamin C, such as peppers, sauerkraut, Brussels sprouts or  potatoes ,  or a glass of orange juice with the meal. Because  vitamin C  improves the absorption of iron from plant foods.
4. It is best to  avoid coffee ,  tea  and cola with iron-rich meals – keep your distance for at least half an hour, because these foods are considered iron robbers.
5. If you have an iron deficiency, you can take iron supplements if recommended by a doctor. In addition to iron tablets, there are also foods fortified with iron, such as special  juices .

Detailed information on  iron- rich diets and foods with a lot of iron  can be found here.

Preparations with iron: what should be considered?

If an iron deficiency has been diagnosed by an appropriate test, the deficiency can be compensated for in mild cases by selecting appropriate foods. Sometimes, however, iron-containing preparations are prescribed, mostly in the form of iron tablets, but also as capsules, juice or drops. Such dietary supplements can quickly help to replenish depleted iron stores. It is important never to take such remedies without a doctor’s recommendation, otherwise an excess of iron can occur.

However, even with the recommended dosage, side effects such as black-colored stools, upper abdominal pain,  heartburn , digestive problems or  nausea  can occur.

Anyone taking iron tablets should know that iron and  zinc , calcium or magnesium can interfere with each other’s absorption. Therefore, iron supplements should not be taken with these mineral supplements. Iron tablets are best taken away from meals on an empty stomach.

Treatment for severe iron deficiency

If an illness is the cause of the iron deficiency, it should always be treated in order to remedy the iron deficiency as well. If an iron absorption disorder in the intestine is the cause, injection solutions with iron can also be administered. Severe anemia may require a blood transfusion.

It can take three to six weeks for iron deficiency anemia to improve. It is recommended that iron supplements be taken for an additional six months afterward to replenish iron stores. Regular blood tests are advisable to monitor iron levels.

Risk groups: who is at risk?

Anyone can be affected by iron deficiency. However, in some groups of people the risk of iron deficiency is particularly high. The following groups of people have an increased risk of iron deficiency and should have their iron levels checked regularly by a doctor:

• women, especially during pregnancy and breastfeeding
• children and young people
• elderly people
• chronically ill
• Vegetarians  and  vegans  _
• endurance athletes
• People who frequently donate blood

Increased iron requirements in women

Compared to men, women have a 50 percent higher need for iron and are more at risk of developing iron deficiency due to the blood loss during menstruation: Young women in particular with heavy menstrual bleeding therefore show corresponding symptoms relatively often.

Iron deficiency in pregnancy

Iron requirements are even higher during pregnancy. The growing uterus with the placenta and the unborn child must be supplied with oxygen, and the fetus also builds up iron stores. Therefore, the iron requirement during pregnancy increases threefold. The greatest need is in the second and third trimester of pregnancy.

A sufficient iron depot not only has a positive effect on the general well-being of the mother-to-be, but also has a positive effect on the physical and mental development of the child.

Iron deficiency in children and adolescents

A newborn child takes part of the iron supply at birth, which lasts about four months. In addition, the baby is supplied with iron through breast milk, although  milk  is generally low in iron. About 50 percent of the iron in breast milk can be used by infants. From the sixth month of life at the latest, iron-rich supplementary food should be fed, because babies and small children can also have an iron deficiency. Green vegetables, small portions of meat and porridge enriched with red fruit juices are considered good sources of iron. In younger children, if iron deficiency anemia goes undetected for a long time, there is a risk that intellectual development and brain maturation will be impaired.

As the child grows, muscle mass and blood volume increase, which means that the need for iron also increases. Growing children therefore sometimes suffer from iron deficiency and the typical symptoms such as tiredness, listlessness and poor concentration. Growth spurts in school children and adolescents and the onset of menstruation in young girls are typical triggers of acute iron deficiency.

Older people often do not meet their iron requirements

In old age, the individual iron requirement can often no longer be met. Older people often no longer have as much appetite, and the food intake is correspondingly reduced or one-sided. In addition, ill-fitting dentures can spoil the enjoyment of meat meals.

Another reason for iron deficiency in old age is the reduced absorption of iron due to disorders in the gastrointestinal tract or the side effects of medication. In the case of an iron deficiency in old age due to difficulties with chewing, for example, pureed meals can help.

Iron deficiency in diseases

Severe blood loss from accidents, injuries or gastrointestinal ulcers, as well as taking painkillers; Gastric acid inhibitors or drugs containing cortisone result in iron being lost.

People suffering from chronic kidney disease,  cystic fibrosis  or gastrointestinal diseases such as  Crohn’s disease , chronic inflammation of the gastric mucosa or  celiac disease  usually have too little iron in their blood because it is not absorbed by the body in the first place or is excreted to a greater extent. Iron deficiency can also occur in cancer patients.

Vegetarian diet: pay attention to iron intake

Vegetable iron, for example in bread, vegetables, legumes and whole grain products, is only poorly bioavailable, i.e. the body can hardly absorb it. Animal iron, on the other hand, such as from red meat, can be better utilized by the body.

Vegetarians and vegans should therefore make sure to combine plant-based iron sources with vitamin C (e.g. a glass of freshly squeezed orange juice): This improves iron absorption from plant-based foods.

Sometimes an iron substitution with iron preparations is recommended by a doctor, whereby, for example, Kräuterblut® or  dragees  with an easily digestible iron-II-compound (heme iron) have proven to be particularly effective.

Iron deficiency due to permanent blood donation and endurance sports

Iron is also removed from the body with the blood. People who donate blood regularly should therefore prevent this by eating an iron-rich diet or, if necessary, taking iron supplements.

The following applies to people who do intensive sport: During intensive training, the iron values ​​are around ten percent below normal values, because on the one hand more oxygen (and therefore iron) is required and on the other hand more iron is excreted through sweat. But even a slight deficiency reduces performance, you become listless and listless. Athletes should be examined by a doctor to find the right therapy and amount of iron for them.